U.S. patent application number 15/091920 was filed with the patent office on 2016-08-04 for surgical device including buttress material.
The applicant listed for this patent is Covidien LP. Invention is credited to Sally Carter, Thomas Casasanta, Andrew Miesse.
Application Number | 20160220257 15/091920 |
Document ID | / |
Family ID | 47631206 |
Filed Date | 2016-08-04 |
United States Patent
Application |
20160220257 |
Kind Code |
A1 |
Casasanta; Thomas ; et
al. |
August 4, 2016 |
SURGICAL DEVICE INCLUDING BUTTRESS MATERIAL
Abstract
The present disclosure provides a surgical stapling device and a
method for joining tissue portions. The surgical stapling device
includes a handle assembly and a tubular body portion supported on
a distal end of the handle assembly having a staple cartridge
assembly containing a plurality of surgical staples in an annular
array. An anvil assembly is at a distal end of the stapling device
and has a shaft for removably connecting the anvil assembly to the
tubular body portion. The anvil assembly and tubular body portion
are juxtaposed with respect to one another along the shaft and are
arranged so as to be approximated with respect to one another. A
support member extends from the tubular body portion towards the
anvil assembly and a buttress material is supported by the support
member and removably attached to the support member where the
buttress material is disposed between the anvil assembly and the
staple cartridge assembly.
Inventors: |
Casasanta; Thomas;
(Kensington, CT) ; Miesse; Andrew; (Durham,
CT) ; Carter; Sally; (Nashua, NH) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Covidien LP |
Mansfield |
MA |
US |
|
|
Family ID: |
47631206 |
Appl. No.: |
15/091920 |
Filed: |
April 6, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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13358551 |
Jan 26, 2012 |
9326773 |
|
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15091920 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/1155 20130101;
A61B 17/105 20130101; A61B 17/07292 20130101; A61B 17/115 20130101;
A61B 2017/07214 20130101; A61B 17/068 20130101 |
International
Class: |
A61B 17/115 20060101
A61B017/115; A61B 17/068 20060101 A61B017/068; A61B 17/10 20060101
A61B017/10 |
Claims
1-20. (canceled)
21. A surgical stapling device for joining tissue portions,
comprising: a handle assembly; a tubular body portion supported on
a distal end of the handle assembly, the tubular body portion
including: a staple cartridge assembly containing a plurality of
surgical staples in an annular array, the staple cartridge assembly
defining a tissue contacting surface on a distal end thereof; and a
central shaft extending axially through the staple cartridge
assembly towards the distal end of the staple cartridge assembly,
the central shaft including a tissue contacting platform at a
distal end thereof, the distal end of the central shaft defining an
opening extending at least partially through the central shaft,
wherein the tissue contacting platform of the central shaft is
coplanar with the tissue contacting surface of the staple cartridge
assembly, such that the tissue contacting platform of the central
shaft does not extend beyond the tissue contacting surface of the
staple cartridge assembly; an anvil assembly at a distal end of the
surgical stapling device, the anvil assembly having a shaft for
removably locating the anvil assembly within the opening of the
central shaft of the tubular body portion, the anvil assembly and
tubular body portion being juxtaposed with respect to one another
along the shaft of the anvil assembly and arranged so as to be
approximated with respect to one another; and a buttress material
supported by the tissue contacting platform of the central shaft
and removably attached thereto, the buttress material being
disposed between the anvil assembly and the staple cartridge
assembly.
22. The surgical stapling device according to claim 21, wherein the
tissue contacting platform of the central shaft defines a
substantially circular platform.
23. The surgical stapling device according to claim 22, wherein the
central shaft defines a proximal portion and a distal portion, the
distal portion having an outer diameter which is larger than an
outer diameter of the proximal portion, the circular platform being
disposed on the distal portion of the central shaft.
24. The surgical stapling device according to claim 23, wherein an
inner diameter of the proximal and distal portions of the central
shaft are substantially the same.
25. The surgical stapling device according to claim 21, wherein a
distal end of the central shaft is substantially radially aligned
with a distal end of the staple cartridge assembly.
26. The surgical stapling device according to claim 21, wherein the
staple cartridge assembly defines an inner annular edge and the
central shaft defines an outer annular edge, wherein a gap is
defined between the inner annular edge of the staple cartridge
assembly and the outer annular edge of central shaft.
27. The surgical stapling device according to claim 21, wherein the
tissue contacting platform of the central shaft defines a
substantially polygonal platform, the buttress material being
attachable to the polygonal platform.
28. The surgical stapling device according to claim 24, wherein a
difference in size between the inner and outer diameters of the
distal portion of the central shaft defines a size of the circular
platform.
29. The surgical stapling device according to claim 23, wherein the
central shaft includes a transition portion between the distal
portion and the proximal portion.
30. The surgical stapling device according to claim 21, wherein the
tissue contacting platform of the central shaft includes at least
one attachment point for receiving and securing the buttress
material to the tissue contacting platform.
31. The surgical stapling device according to claim 24, wherein the
inner diameter of the proximal and distal portions of the central
shaft define a diameter of the opening of the central shaft.
32. The surgical stapling device according to claim 31, wherein the
buttress material includes an aperture having a diameter that is
larger than the diameter of the opening of the central shaft.
33. The surgical stapling device according to claim 32, wherein the
aperture of the buttress material is coaxial with the opening of
the central shaft when the buttress material is supported by the
central shaft.
34. The surgical stapling device according to claim 32, wherein a
radial gap is defined between the aperture of the buttress material
and the opening of the central shaft when the buttress material is
supported by the central shaft.
35. The surgical stapling device according to claim 21, wherein the
buttress material is positioned proximate to the tissue contacting
surface of the staple cartridge assembly when the buttress material
is supported by the central shaft.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a divisional and claims the benefit of
and priority to U.S. patent application Ser. No. 13/358,551 filed
Jan. 26, 2012, the entire disclosure of which is incorporated by
reference herein.
BACKGROUND
[0002] 1. Technical Field
[0003] The present disclosure relates to buttress materials for use
with a surgical stapling device and, more particularly, to a method
and structure for attaching a buttress material to a surgical
stapling device for use in anastomosis procedures.
[0004] 2. Background of Related Art
[0005] Staples have traditionally been used to replace suturing
when joining or anastomosing various body structures such as, for
example, the bowel or bronchus. The surgical stapling devices
employed to apply these staples are generally designed to
simultaneously cut and seal an extended segment of tissue in a
patient, thus vastly reducing the time and risks of such
procedures.
[0006] Linear or annular surgical stapling devices are employed by
surgeons to sequentially or simultaneously apply one or more linear
rows of surgical fasteners, e.g., staples or two-part fasteners, to
body tissue for the purpose of joining segments of body tissue
together and/or for the creation of anastomoses. Linear surgical
stapling devices generally include a pair of jaws or finger-like
structures between which body tissue to be joined is placed. When
the surgical stapling device is actuated and/or "fired", firing
bars move longitudinally and contact staple drive members in one of
the jaws, and surgical staples are pushed through the body tissue
and into/against an anvil in the opposite jaw thereby crimping the
staples closed. A knife blade may be provided to cut between the
rows/lines of staples. Examples of such surgical stapling devices
are described in U.S. Pat. Nos. 4,354,628, 5,014,899 and 5,040,715,
the entirety of each of which is incorporated herein by
reference.
[0007] Annular surgical stapling devices generally include an
annular staple cartridge assembly including a plurality of annular
rows of staples, typically two, an anvil assembly operatively
associated with the annular cartridge assembly, and an annular
blade disposed internal of the rows of staples. Examples of such
annular surgical stapling devices are described in U.S. Pat. Nos.
5,799,857 and 5,915,616 to Robertson et al., the entirety of each
of which is incorporated herein by reference.
[0008] In general, an end-to-end anastomosis stapler typically
places an array of staples into the approximated sections of a
patient's bowels or other tubular organs. The resulting anastomosis
contains an inverted section of bowel which contains numerous "B"
shaped staples to maintain a secure connection between the
approximated sections of bowel.
[0009] For most procedures, the use of bare staples, with the
staples in direct contact with the patient's tissue, is generally
acceptable. The integrity of the tissue will normally serve to
prevent the staples from tearing out of the tissue and compromising
the sealing before healing has occurred. However, in some surgical
operations, surgical supports, e.g., meshes or buttress materials,
are employed by surgeons in combination with linear stapling
devices to bridge, repair and/or reinforce tissue defects within a
patient, especially those occurring in the abdominal wall, chest
wall, diaphragm, and other musculo-aponeurotic areas of the body.
Examples of suitable surgical supports are disclosed in U.S. Pat.
Nos. 3,054,406, 3,124,136, 4,347,847, 4,655,221, 4,838,884,
5,002,551, and 7,942,890, the entirety of each of which is
incorporated herein by reference.
[0010] When the staples are applied in surgical procedures
utilizing surgical supports (i.e., reinforcing material), the legs
of the staple typically pass from the cartridge jaw through a layer
of the surgical support, and through the patient's tissue before
encountering the anvil jaw.
[0011] While the surgical supports described above are used in
conjunction with linear surgical stapling devices, the need exists
for annular support structures for use in conjunction with annular
or circular surgical stapling devices, for example, an end-to-end
anastomosis stapler such as a Model "EEA.TM." instrument available
from United States Surgical, a Division of Tyco Health-Care Group,
LP, Norwalk, Conn. and disclosed in U.S. Pat. No. 5,392,979 to
Green et al.
[0012] One possible side effect of any end-to-end bowel anastomosis
is its tendency to undergo stenosis, which can decrease the
diameter of the lumen over time. Accordingly, the need exists for
an annular surgical structure which operates in conjunction with
any end-to-end, annular, or circular anastomosis or stapling device
and assists in keeping open the lumen of the anastomosed bowel or
other tubular organ over time.
[0013] A need also exists for an annular support structure which
operates in conjunction with any end-to-end, annular or circular
stapling device to reduce the trauma suffered by the patient,
reduce the instances of leakage, reduce the instances of bleeding,
and create a relatively strong bond between adjacent body
tissues.
SUMMARY
[0014] The present disclosure provides a surgical stapling device
having support members for supporting and attaching a buttress
material thereto and a method of using the same.
[0015] In one embodiment, a surgical stapling device for joining
tissue portions is disclosed. The surgical stapling device includes
a handle assembly and a tubular body portion supported on a distal
end of the handle assembly having a staple cartridge assembly
containing a plurality of surgical staples in an annular array. An
anvil assembly is at a distal end of the surgical stapling device
and has a shaft for removably connecting the anvil assembly to the
tubular body portion. The anvil assembly and tubular body portion
are juxtaposed with respect to one another along the shaft and are
arranged so as to be approximated with respect to one another. A
support member extends from the tubular body portion towards the
anvil assembly and a buttress material is supported by the support
member and removably attached to the support member where the
buttress material is disposed between the anvil assembly and the
staple cartridge assembly.
[0016] In one embodiment the buttress material includes an
attachment member which extends from the buttress material to the
support member and is attachable to the support member to removably
secure the buttress material to the support member. In another
embodiment, the tubular body portion includes a plurality of
support members and the buttress material is removably attachable
to the plurality of support members. In another embodiment, the
support member is disposed in an opening extending at least
partially through the tubular body portion. In another embodiment,
the support member extends distally from the opening in an axial
direction where a distal end of the support member is substantially
radially aligned with a distal face of the tubular body portion. In
another embodiment, the buttress material is positioned proximate
to a tissue contacting surface of the staple cartridge assembly
when the buttress material is attached to the support member.
[0017] In one embodiment the tubular body portion includes an
elongate member extending axially therefrom and defining a passage
extending at least partially therethrough for reception of the
shaft of the anvil assembly. In another embodiment, the support
member is radially disposed between the elongate member and the
staple cartridge assembly. In another embodiment, the tubular body
portion further includes a knife disposed between the elongate
member and the tubular body portion. The knife is actuatable from a
first proximal position to a second distal position to sever the
tissue portions during firing of the surgical stapling device. In
another embodiment, the support member is radially disposed between
the elongate member and the knife.
[0018] In another embodiment, a surgical stapling device for
joining tissue portions is disclosed. The surgical stapling device
includes a handle assembly and a tubular body portion supported on
a distal end of the handle assembly having a staple cartridge
assembly containing a plurality of surgical staples in an annular
array. An anvil assembly is at a distal end of the stapling device
and has a shaft for removably connecting the anvil assembly to the
tubular body portion. The anvil assembly and tubular body portion
are juxtaposed with respect to one another along the shaft and are
arranged so as to be approximated with respect to one another. An
elongate member extends from the tubular body portion towards the
anvil assembly and includes an opening extending at least partially
therethrough for receiving the shaft of the anvil assembly. A
buttress material is supported by the elongate member and removably
attached thereto where the buttress material is disposed between
the anvil assembly and the staple cartridge assembly.
[0019] In one embodiment, the elongate member defines a
substantially circular platform at a distal end thereof and the
buttress material is attachable to the circular platform. In
another embodiment, the elongate member defines a proximal portion
and a distal portion where the distal portion has an outer diameter
which is larger than an outer diameter of the proximal portion and
the circular platform is disposed on the distal portion. In another
embodiment, the inner diameter of the proximal and distal portions
are substantially the same. In another embodiment, the buttress
material is adhered to a distal end of the elongate member. In
another embodiment, a distal end of the elongate member is
substantially radially aligned with a distal end of the staple
cartridge assembly.
[0020] A method of using buttress material with a surgical stapling
device is also disclosed. The method including the steps of
positioning the buttress material at least partially between an
anvil assembly and a cartridge assembly of the surgical stapling
device and extending from the cartridge assembly to a support
member of the surgical stapling device, securing the buttress
material to the support member, receiving body tissue between the
anvil assembly and the cartridge assembly, grasping the body tissue
between the anvil assembly and the cartridge assembly, and firing
the surgical stapling device to drive a plurality of staples from
the cartridge assembly through the buttress material and the body
tissue to thereby secure a first portion of the buttress material
to the body tissue.
[0021] In one embodiment, the step of firing the surgical stapling
device includes the step of transitioning a knife between a first
proximal position and a second distal position to sever the first
portion of the buttress material from a second portion of the
buttress material which is not secured to the body tissue, the
second portion of the buttress material remaining secured to the
support member. In another embodiment, the support member is
disposed radially inward of the cartridge assembly with the knife
disposed therebetween and the step of transitioning the knife
includes the step of the knife severing the buttress material
extending between the cartridge assembly and the support member. In
another embodiment, the second portion of the buttress material is
a plurality of attachment members extending from the first portion
of the buttress material to the support member and the step of
transitioning the knife includes the step of the knife severing the
plurality of attachment members from the first portion of the
buttress material.
BRIEF DESCRIPTION OF DRAWINGS
[0022] The accompanying drawings, which are incorporated in and
constitute a part of this specification, illustrate embodiments of
the disclosure and, together with a general description of the
disclosure given above and the detailed description of the
embodiments given below, serve to explain the principles of the
disclosure, wherein:
[0023] FIG. 1 is a perspective view of an exemplary annular
surgical stapling device according to the present disclosure;
[0024] FIG. 2 is a perspective view of a buttress material in
accordance with an embodiment of the present disclosure, for use
with the annular surgical stapling device of FIG. 1;
[0025] FIG. 3 is an enlarged perspective view of an anvil assembly
and a tubular body portion of the annular surgical stapling device
of FIG. 1;
[0026] FIG. 4 is a top, plan view of the tubular body portion of
FIG. 3, illustrating the support members of an embodiment of the
present disclosure;
[0027] FIG. 5 is a top, plan view of the tubular body portion of
FIG. 3, illustrating the buttress material supported on the support
members;
[0028] FIG. 6 is a schematic, longitudinal, cross-sectional view of
the anvil assembly and tubular body portion of FIG. 3, as taken
through 6-6 of FIG. 3, illustrating the buttress material supported
on the support members;
[0029] FIG. 7 is a schematic, perspective cut-away view of a
tubular body portion of an annular surgical stapling device
according to another embodiment of the present disclosure;
[0030] FIG. 8 is a schematic, longitudinal, cross-sectional view of
the annular surgical stapling device of FIG. 7, as taken through
8-8 of FIG. 7;
[0031] FIG. 9 is a top, plan view of the tubular body portion of
FIG. 7, illustrating a buttress material attached to a central
shaft of the tubular body portion;
[0032] FIG. 10 is a plan view of a buttress material, according to
another embodiment of the present disclosure, for use with an
annular surgical stapling device;
[0033] FIG. 11 is a top, plan view of the buttress material of FIG.
10, illustrating the buttress material supported on the support
members of a tubular body portion of the annular surgical stapling
device;
[0034] FIG. 12 is a schematic, longitudinal, cross-sectional view
of the annular surgical stapling device of FIG. 3, illustrating the
buttress material of FIG. 10 supported on the support members of
the tubular body portion with tissue disposed between the buttress
material and the anvil assembly of the annular surgical stapling
device; and
[0035] FIG. 13 is a perspective view of the intestinal area of a
patient, illustrating a method of positioning the annular surgical
stapling device of FIG. 1 to connect the anvil assembly to the
tubular body portion.
DETAILED DESCRIPTION OF EMBODIMENTS
[0036] Embodiments of the presently disclosed annular surgical
stapling device will now be described in detail with reference to
the drawing figures wherein like reference numerals identify
similar or identical elements. As used herein and as is
traditional, the term "distal" refers to that portion which is
furthest from the user while the term "proximal" refers to that
portion which is closest to the user.
[0037] Referring initially to FIG. 1, an annular surgical stapling
device for use with a buttress material is disclosed herein and is
generally designated as 10. Surgical stapling device 10 includes a
handle assembly 12 having at least one pivotable actuating handle
member 14, and an advancing member 16. Extending from handle member
12, there is provided a tubular body portion 100 which may be
constructed so as to have a curved shape along its length. Body
portion 100 terminates in a staple cartridge assembly 102 which
includes at least one annular array of staple receiving slots 104
having a staple (not shown) disposed in each one of staple
receiving slots 104. For example, staple cartridge assembly may
include one, two, or more than two annular arrays of staple
receiving slots 104.
[0038] Staple cartridge assembly 102 may be fixedly connected to
the distal end of tubular body portion 100 or may be configured to
concentrically fit within the distal end of tubular body portion
100. Typically, staple cartridge assembly 102 includes a staple
pusher (not shown) including a proximal portion having a generally
frusto-conical shape and a distal portion defining two concentric
rings of peripherally spaced fingers (not shown), each one of which
is received within one of the respective staple receiving slots
104.
[0039] Typically, a knife (not shown), substantially in the form of
an open cup with the rim thereof defining a knife edge, is disposed
within staple cartridge assembly 102 and mounted to a distal
surface of a staple pusher (not shown). The knife edge is disposed
radially inward of the pair of annular arrays of staples.
Accordingly, in use, as the staple pusher is advanced, the knife is
also advanced axially outward.
[0040] Positioned distally of staple cartridge assembly 102 there
is provided an anvil assembly 200 including an anvil member 202 and
a shaft 204 operatively associated therewith for removably
connecting anvil assembly 200 to a distal end portion of stapling
device 10.
[0041] Reference may be made to U.S. Pat. No. 5,915,616 to Viola et
al., the entire contents of which are incorporated herein by
reference, for a detailed discussion of the construction and
operation of annular stapling device 10. U.S. Pat. No. 5,915,616 to
Viola et al. is hereby incorporated by reference herein, in its
entirety.
[0042] Referring now to FIGS. 1, 3, 4, 5 and 6, body portion 100 of
stapling device 10 includes a plurality of support members 108
extending from a central shaft 110. One or more support members 108
are adapted to support and secure a buttress material 300 adjacent
to or proximate to a tissue contacting surface 106 of staple
cartridge assembly 102. As seen in FIG. 6, each support member 108
includes a base portion 112 extending radially outward from a
proximal portion 114 of central shaft 110 and an attachment portion
116 extending distally from base portion 112. It is contemplated
that each base portion 112 may alternatively extend from central
shaft 110 at any position along its length up to and including a
distal end 118 of central shaft 110, where, for example, each base
portion 112 may extend from central shaft 110 at a middle portion
120 or at distal end 118. It is also contemplated that each support
member 108 may extend directly from tubular body portion 100 rather
than central shaft 110.
[0043] It is contemplated that each attachment portion 116 may be
radially spaced from central portion 110 or may be adjacent to or
abutting central portion 110 where no base portion 112 would be
necessary. Any number of support members 108 may be provided at
various positions radially about central portion 110, such as, for
example, one, two, four or more support members 108. Support
members 108 may be positioned radially about central shaft 110 in
any configuration where, for example, each support member may be
offset by ninety degrees (See FIGS. 4 and 5) or may be offset by
more degrees or less degrees as desired. It is also contemplated
that the offset between a first adjacent pair of support members
108 may be greater or less than the offset between a second
adjacent pair of support members 108. As seen in FIGS. 4 and 5,
attachment portions 116 of each support member 108 may be
positioned at a different spacing from central portion 110 and
multiple support members 108 having attachment portions 116 with
different spacing from central portion 110 may be included at the
same time.
[0044] Base portions 112 of support members 108 may define a linear
shape or may instead define an arcuate shape where, for example, a
portion of base portions 112 curve distally away from central
portion 110.
[0045] Each support member 108 may define a transverse
cross-section having a substantially square shape or may define a
transverse cross-section having a circular, oval, rectangular,
triangular, polygonal or other shape suitable for supporting a
buttress material 300 on a distal end 122 of the support member
108. It is contemplated that the transverse cross-section of base
portion 112 and attachment portion 116 of each support member 108
may be substantially the same or that the base portion 112 and
attachment portion 116 may have different transverse
cross-sections.
[0046] Distal end 122 of each support member 108 may permanently or
removably secure buttress material 300 in place and buttress
material 300 may be attached to distal end 122 of each support
member 108 by various methods including, for example, adhesives,
ultrasonic welding, tacking, stapling, hook and loop, or other
methods of attachment which are suitable to either permanently
affix or removably affix buttress material 300 to each support
member 108.
[0047] As seen in FIG. 6, distal end 122 of each support member 108
may be positioned at the same radial plane as tissue contacting
surface 106 of staple cartridge assembly 102 relative to central
shaft 110 where, when buttress material 300 is affixed or attached
to support member 108, buttress material 300 defines a
substantially linear radial configuration between support 108 and
tissue contacting surface 106 of staple cartridge assembly 102. It
is also contemplated that distal end 122 of each support member 108
may be located longitudinally proximal or distal of tissue
contacting surface 106 of staple cartridge assembly 102.
[0048] Referring now temporarily to FIG. 2, buttress material 300
is generally annular in shape and includes an inner portion 302, a
middle portion 304, and an outer portion 306. A substantially
centrally located aperture 308, defined by the inner circumference
of inner portion 302 is formed through buttress material 300.
Buttress material 300 may be any shape sufficient to provide
support for anastomosis of tissue after surgical stapling device 10
has been fired including, for example, a square, a circle, an oval,
a triangle or any other polygonal or other shape.
[0049] In one embodiment, as seen in FIG. 6, buttress material 300
is sized such that when buttress material 300 is affixed or
attached to support members 108, outer portion 306 of buttress
material 300 extends radially beyond staple receiving slots 104
(See FIGS. 3-5) of staple cartridge assembly 102. Additionally,
aperture 308 of buttress material 300 is sized to at least receive
shaft 204 of anvil assembly 200 therethrough. Aperture 308 of
buttress material 300 may also be sized to receive central shaft
110 of tubular body portion 100 therethrough. In another
embodiment, the distance between outer portion 306 of buttress
material 300 and inner portion 302 of buttress material 300 is
substantially equal to a width of a tissue contacting surface 106
of staple cartridge assembly 102.
[0050] Each portion 302, 304, and 306 of buttress material 300 may
be fabricated from surgical grade, biocompatible, non-absorbable
material (i.e. permanent) or absorbable material (i.e.
non-permanent) mesh or material desirably impregnated with an
adhesive, sealant and/or other medicament. It is also contemplated
that each portion may be a composite of both a non-absorbable and
an absorbable material. Suitable materials for the fabrication of
buttress material 300 and suitable adhesives, sealants, and/or
medicaments for impregnation in or application to buttress material
300 may be found, for example, in U.S. Pat. No. 7,942,890,
referenced above. U.S. Pat. No. 7,942,890 is hereby incorporated by
reference herein, in its entirety.
[0051] In another embodiment of the present disclosure, as seen in
FIGS. 7-9, an annular surgical stapling device 1000 is disclosed
including a tubular body portion 1100 which is similar to tubular
body portion 100. In this embodiment, a staple cartridge assembly
1102 of tubular body portion 1100 includes a central shaft 1110
having a proximal portion 1114 with a first smaller thickness and a
distal portion 1116 with a second larger thickness. For example,
central shaft 1110 defines an inner diameter which is substantially
the same for both the proximal and distal portions 1114 and 1116
for receiving the shaft 204 of anvil assembly 200. The outer
diameter of central shaft 1110 is smaller at the proximal portion
1114 and larger at the distal portion 1116. The difference between
the inner and outer diameters defines a platform 1120 at a distal
end 1118 of central shaft 1110 for supporting buttress material
300.
[0052] Central shaft 1110 may transition from the smaller outer
diameter to the larger outer diameter gradually along the
longitudinal length of central shaft 1110 where, for example, the
outer diameter gradually tapers outward from proximal to distal, or
central shaft 1110 may transition from the smaller outer diameter
to the larger outer diameter by defining an arcuate transition
portion 1124, as seen in FIGS. 7 and 8. It is contemplated that
central shaft 1110 may have any configuration for transitioning
from the smaller outer diameter at the proximal portion 1114 to the
larger outer diameter at the distal portion 1116 to increase the
thickness of central shaft 1110 at the distal portion 1116 thereof
to provide platform 1120, including, for example, a gentle tapered
transition, an arcuate transition, or a radial extrusion from
proximal portion 1114.
[0053] Platform 1120 may define any shape suitable for providing an
attachment surface for securing buttress material 300. For example,
platform 1120 may be circular, square, rectangular, triangular,
oval, starred, spoked, or any other polygonal shape or suitable
shape.
[0054] As discussed above, buttress material 300 may be attached to
platform 1120 through any means of attachment or affixation
including, for example, adhesives, ultrasonic welding, tacking,
stapling, hook and loop, or other methods of attachment which are
suitable to either permanently affix or removably affix buttress
material 300 to platform 1120. For example, platform 1120 may
include attachment points 1122 (See FIG. 9) for receiving and
securing buttress material 300 to platform 1120. It is contemplated
that support members, as described above, may also be included to
assist in supporting and affixing buttress material 300. The
attachment methods disclosed in U.S. patent application Ser. No.
13/094,893, filed Apr. 27, 2011, may also be used to attach the
buttress material to the support member or platform discussed
above. U.S. patent application Ser. No. 13/094,893 is hereby
incorporated by reference herein, in its entirety. The buttresses
disclosed herein may be made from the materials disclosed in U.S.
patent application Ser. No. 13/094,893, filed Apr. 27, 2011. U.S.
patent application Ser. No. 13/094,893 is hereby incorporated by
reference herein, in its entirety.
[0055] In another embodiment of the present disclosure, as seen in
FIGS. 10-12, a buttress material 3000 is disclosed which is similar
to buttress material 300. Buttress material 3000 includes an inner
portion 3002, a middle portion 3004, an outer portion 3006 and
defines an aperture 3008 therethrough. In this embodiment, aperture
3008 is substantially larger than central shaft 110 of tubular body
portion 100 where, for example, aperture 3008 may have a diameter
substantially equal to the inner diameter of staple cartridge
assembly 102. It is contemplated that aperture 3008 may also be
smaller than the inner diameter of staple cartridge assembly
102.
[0056] Buttress material 3000 is configured for positioning
adjacent tissue contacting surface 106 of staple cartridge assembly
102 and may define a donut like shape which is substantially
equivalent in width to the width of tissue contacting surface 106.
It is contemplated that buttress material 3000 may alternatively
have a width which is greater than that of tissue contacting
surface 106 and that buttress material 300 may extend radially
outward past tissue contacting surface 106 and/or radially inward
towards support members 108 and central shaft 110.
[0057] Buttress material 3000 is securable to support members 108
through the use of a plurality of attachment members 3010 extending
from inner portion 3002 into aperture 3008 towards central shaft
110. Attachment members 3010 allow buttress material 3000 to be
supported by and attached or affixed to support members 108 with a
minimal amount of material. This reduces overall costs for buttress
material 3000 and reduces the force necessary to separate
attachment members 3010 from the rest of buttress material 3000,
during firing by, for example, a knife. Attachment members 3010 may
be configured to break away or to be severed from buttress material
3000 after or during firing and may include perforations, shearable
sections, or other mechanisms suitable to facilitating the
separation of attachment members 3010 from the rest of buttress
material 3000.
[0058] Attachment members 3010 may be attached or affixed to
attachment portion 116 of support members 108 in the same manner as
described above with regard to buttress material 300 including, for
example, adhesives, ultrasonic welding, tacking, stapling, hook and
loop, or other methods of attachment which are suitable to either
permanently affix or removably affix attachment members 3010 to
support members 108.
[0059] Attachment members 3010 may define a rectangular shape or
may define other shapes including, for example, triangular, square,
semicircular, or other shapes suitable for supporting buttress
material 3000 and attaching or affixing buttress material 3000 to
support members 108 or platform 1020.
[0060] Buttress material 3000 and attachment members 3010 may be
made from any of the materials describe above for buttress material
300 and found in U.S. Pat. No. 7,942,890, referenced above. One or
more of inner portion 3002, middle portion 3004, outer portion 3006
and attachment members 3010 may be made from the same material or
one or more of inner portion 3002, middle portion 3004, outer
portion 3006, and attachment members 3010 may be made from
different materials.
[0061] Turning now to FIGS. 12 and 13, there is illustrated the use
of annular surgical stapling device 10 and detachable anvil
assembly 200 in an anastomosis procedure to effect joining of
intestinal sections 20 and 22. The anastomosis procedure is
typically performed using minimally invasive surgical techniques
including laparoscopic means and instrumentation. At the point in
the procedure shown in FIG. 13, a diseased intestinal section has
been previously removed, anvil assembly 200 has been applied to the
operative site either through a surgical incision or transanally
and positioned within intestinal section 22, and tubular body
portion 100 of annular surgical stapling device 10 has been
inserted transanally into intestinal section 20. Intestinal
sections 20 and 22 are also shown temporarily secured about their
respective components (e.g., shaft 204 of anvil assembly 200, and
the tissue contacting surface 106 of tubular body portion 100).
[0062] According to one method, as seen in FIGS. 6, 8, 12, and 13,
buttress material 300 may be placed onto support members 108 of
tubular body portion 100 (or platform 1120 of tubular body portion
1000) prior to the coupling of anvil assembly 200 to the central
shaft 110 of tubular body portion 100. Tubular body portion 100 may
come with buttress material 300 pre-attached to support members 108
(or platform 1120). Alternatively the surgeon may attach buttress
material 300 to support members 108 (or platform 1120) prior to
use. With buttress material 300 secured in place, the surgeon
maneuvers anvil assembly 200 until the proximal end of shaft 204 is
inserted into the central shaft 110 of tubular body portion 100.
Central shaft 110 is now engaged to shaft 204 with intestinal
sections 20 and 22 disposed between anvil assembly 200 and staple
cartridge assembly 102. As seen in FIG. 12, for example, buttress
material 300 is disposed between cartridge assembly 102 and
intestinal sections 20 and 22.
[0063] Anvil assembly 200 and tubular body portion 100 are then
approximated to approximate intestinal sections 20, 22 and capture
buttress material 300 between intestinal section 20 and tissue
contacting surface 106 of staple cartridge assembly 102. Surgical
stapling device 10 is then fired to staple buttress material 300
and intestinal sections 20, 22 together and the knife is actuated
to cut the portion of tissue and buttress material 300 disposed
radially inward of the knife, to complete the anastomosis. For
example, the knife may cut through a portion of buttress material
300 and may be aligned with perforations or other shearable
sections of buttress material 300 to require less force for
cutting. Alternatively when a buttress material 3000, having
attachment members 3010 is provided, the knife may cut through a
portion of each attachment member 3010 near inner portion 3002 of
buttress material 3000 where, for example, less force is required
to cut through attachment members 3010 than to cut through buttress
material 300 because less material is provided in the path of the
knife.
[0064] While the use of surgical stapling device 10 has been shown
and described, it is understood and within the scope of the present
disclosure that surgical stapling device 1000 may be operated in
the same or similar manner.
[0065] While several configurations of support members and
platforms have been illustrated and described, it will also be
apparent that various modifications can be made without departing
from the spirit and scope of the present disclosure. For example,
it is envisioned and within the scope of the present disclosure for
a greater or smaller number of support members to be provided. It
is also envisioned that the spacing of support members from the
central shaft may be adjusted and that the spacing or
circumferential position of the support members about the central
shaft may be adjusted. It is also envisioned that a thicker or
thinner central shaft with a larger or smaller platform may be
provided.
[0066] Thus, it should be understood that various changes in form,
detail and application of the buttress materials of the present
disclosure may be made without departing from the spirit and scope
of the present disclosure.
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